Amaurosis Fugax: A Clinical Comparison• Amaurosis fugax (transient monocular blindness) is a symptom of retinal ischemia just as contralateral hemiparesis and sensory loss are symptoms of cerebral ischemia. These symptoms are produced by atherosclerotic stenosis of the carotid vessels at the ipsilateral carotid bifurcation and emboli from these areas causing focal, repetitive, retinal ischemia.A study of 31 endarterectomy patients was undertaken to see if eight patients with amaurosis fugax (25%) could be differentiated from 22 patients with transient cerebral ischemia. The patients with amaurosis fugax were found to be younger. They all had 75% or greater stenosis of the internal carotid artery at the bifurcation on the symptomatic side. They all had unilateral visual symptoms and these symptoms were relieved by surgery. The patients with amaurosis fugax were devoid of cardiac disease, while 45% of the cerebral ischemic patients had documented myocardial disease.Amaurosis fugax (transient monocular blindness) in the setting of clinically significant atheroslerosis of the carotid vessels is an indication for carotid endarterectomy.

The purpose of the observations here presented was to follow the development of function of the thyroid gland during intra-uterine life by a quantitative determination of its iodinecontaining compounds ; and to investigate changes in its histological structure rhich might be correlated with changes in the chemistry of the gland. Since thyroxine, or a protein containing thyroxine, is the active principle of the thyroid, the demonstration of this substance in the gland may be considered a logical test of its function. Recent improvements in the micro-determination of iodine make such a demonstration possible. Consequently, in this study, the quantity of thyroxine iodine, and in addition, the quantities of total iodine, di-iodotyrosine iodine, and inorganic iodine have been deterniiried in a series of glands from fetal pigs. MATERIAL AND METHODSThe fetal pigs were collected under conditions described elsewhere (Plexner and Gersh, '37). The fetal thyroids were usually removed within 2 hours after the death of the mother; occasionally the time interval was 4 hours. The glands were weighed and then dried to constant weight in an oven at 75" to 80°C. After drying they were pulverized and stored in a 133desiccator a t roo111 tciiiperature uiitil usecl. It mas fouiid that thew was iio cliangc~ iii the tIi;r-i*osinc coiitciit after pi*olongccl storage ( 2 iiioiitlis).Tlic thprosiiie coiiteiit IVNS cleterniiiiecl accoiding to tlie micro-metlicd outlined by I'aliiier, Leland ancl Gutman ( '38) u-hicli utilizes the niethocl of iocliiw cl~tci-miiiatioii of Trevorrow aiid Faslieiia ( 3 S ) . 21'roiii 2 to 130 mg. (depeiidiiig 011 the thyroxine content) of tlie powdered glands were liyclrolizcd in 2 N NaOH o~e r a 2 h: H,SO, bath for 16-18 hours. The thyroxine wus tlicn estrac*tcd with 11-bntgl alcohol uiid the extract evaporated to dryness. Tlic asli was dissolved iii water iiiid the iodine liberated by lioatiiig to 195°C. in a digestion mixture of €€-SO,, K , C I *~O~ aiid ( k S 0 , . Phosphorus acid was added a i d the mixture steam-distilled in a closed syteiii through whicli a stream of air was bluwi. Tlie iocliiie was collccted i i t 0.1 N Sa,CO,, ; this solutioii was evapoi*atccl to about 10 cc., ticiclificcl, broniiiie rapor adclecl, and then further evaporated to 5 cc. After iiddiiig potahsiiiiii iodide and starch tlie solution T V~S titrated agaiiist 0.001 S sodiuiii thiosulfate.F o r the iiieasureiiient of the total iodine, the glands w i -e placed direct1:-in the digestion iiiisture aiid the iocliiie w~s determined as above. The amomit of iiiorgaiiic iocliiie w a s fouiid by estractiiig tlie powdcre~d glaiicls with distilled \niter a t room temperature for 12-16 hours. It was fourid there was no increase in the amount of iodine extracted after 8 hours. l'h filtered ext met was ilieii atldccl to tlie digestion Inisturc aiid the iodine determined.It was necessary to resort to a n iiiclirect rriethocl for tlic determination of di-ioclotyrosine. The direct methods either involve consiclerahle loss o r arc impractical fo...

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